Provider Demographics
NPI:1588224810
Name:O'HARA, LEANN (LCSW)
Entity Type:Individual
Prefix:
First Name:LEANN
Middle Name:
Last Name:O'HARA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 SUNRISE TER
Mailing Address - Street 2:
Mailing Address - City:PARLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08859-1819
Mailing Address - Country:US
Mailing Address - Phone:732-795-0644
Mailing Address - Fax:
Practice Address - Street 1:422 MORRIS AVE STE 7
Practice Address - Street 2:
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-6574
Practice Address - Country:US
Practice Address - Phone:908-675-1769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC056733001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical